Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 53721 | KY |
N | 208600000X | Surgeon | 53721 | KY |
Y | 2086X0206X | Surgical Oncologist | 53721 | KY |
NPI | 1205046620 |
---|---|
Provider Name | Dr. Lawrence Andrew Shirley |
First Address | Lexington, KY 40503-1472 |
Second Address | Lexington, KY 40503-1472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0074540 | (05) | OH |